Factors contributing to the differences in peritonitis rates between centers and regions

Despite improvements in connectology, peritoneal dialysis (PD) - associated peritonitis contributes significantly to morbidity and modality failure in patients maintained on PD therapy. A broad spectrum of organisms -gram-positive, gram-negative, fungal, anaerobic - are involved in this complication. In addition, a significant percentage of episodes involve polymicrobial and culture-negative infection. Technological advances are being developed to minimize the incidence of access-related complications such as peritonitis. Many traditional factors such as exit-site infection and poor technique have been already identified. In the present review, we discuss the geographic, patient selection, and clinical issues that can affect peritonitis rates in different areas of the world and in different centers in the same area.

Hemoglobin and HFE gene polymorphisms in Brazilian populations in regions endemic for malaria

Our objective was to determine how the distribution of red blood cell diseases is related to malaria occurrence in north Brazil, a region endemic for malaria. We evaluated the incidence of two mutations in the HFE gene, H63D and C282Y, in two study groups: a control blood donor group, with no indication of malaria infection, and a group constituted of malaria patients of four states of the Amazonian region. The hemoglobin polymorphisms were obtained by HPLC and classical laboratory methodologies, and the two mutations in the HFE gene were assayed by PCR-RFLP. We found a high frequency of alpha thalassemia, but there were no significant differences between blood donors and malaria patients. There were also no significant differences in the frequencies of HbA(2); however, the frequency of HbF was significantly different in individuals with malaria from Para and Rondonia. The mean number of reticulocytes was significantly reduced in the blood donors from the northern region, suggesting an adaptive strategy of these populations to parasitic attack by Plasmodium. Most individuals were heterozygous for the H63D allele of the HFE gene in both study groups. In the blood donors group, the greatest frequency of the H63D allele was found in Caucasians of all the states. In the malaria patients group in Rondonia, there was a high frequency of the H63D allele among the non-Caucasians. In the other states, and in the malaria patients group, the H63D allele was the most frequent among the Caucasians. Based on our results, we suggest that the maintenance of polymorphism of the mutations in the gene HFE can be explained by selective factors other than malaria, or it is due to simple allelic oscillation and by the constant gene flow among the populations in Brazil.

KARYOTYPE AND NUCLEOLUS ORGANIZER REGIONS OF PYRRHULINA CF AUSTRALIS (PISCES, CHARACIFORMES, LEBIASINIDAE)

The mitotic chromosomes and nucleolus organizer regions (NORs) of the Upper Parana Basin fish Pyrrhulina cf. australis were studied. The karyotype (2n = 40; 6st + 34a) is characterized by the presence of four chromosome pairs with NORs, one of them with NORs in both terminal regions. Comparison of this karyotype with those of other Characiformes, revealed a strong similarity to the family Erythrinidae.

Effect of oxytocin on transepithelial transport of water and Na+ in distinct ventral regions of frog skin (Rana catesbeiana)

Thoracic, abdominal, and pelvic fragments of ventral skin of Rana catesbeiana were analysed regarding the effect of oxytocin on: (1) transepithelial water transport; (2) short-circuit current, (3) skin conductance and electrical potential difference; (4) Na+ conductance, the electromotive force of the Nat transport mechanism, and shunt conductance; (5) short-circuit current responses to fast Na+ by K+ replacement in the outer compartment, and (6) epithelial microstructure. Unstimulated water and Na+ permeabilities were low along the ventral skin. Hydrosmotic and natriferic responses to oxytocin increased from thorax to pelvis, Unstimulated Na+ conductance was greater in pelvis than in abdomen, the other electrical parameters being essentially similar in both skin fragments. Contribution of shunt conductance to total skin conductance was higher in abdominal than in pelvic skin. Oxytocin-induced increases of total skin conductance, Na+ conductance, and shunt conductance in pelvis were significantly larger than in abdomen, An oscillatory behaviour of the short-circuit current was observed only in oxytocin-treated pelvic skins. Decrease of epithelial thickness and increase of mitochondria-rich cell number were observed from thorax to pelvis, Oxytocin-induced increases of interspaces were more conspicuous in pelvis and abdomen than in thorax.

ANATOMIC OBSERVATIONS OF THE CORONARY SINUS IN THE DOG (CANIS-FAMILIARIS)

The coronary sinus was investigated in 34 normal adult dogs, in order to verify its formation, tributaries, length and the valves, as well as the relationship of the venous walls to the epicardium and to the myocardium. The valve of the coronary sinus was observed in only 4 cases (1.7 %). In 30 cases (98.3 %) the ostium of the coronary sinus was lacking a valve. The valve of Vieussens double, was found at the level of the transition between the great cardiac vein and the coronary sinus, as well as others parietal venous valves. A comparison with the human pattern was made, particularly regarding the action of the valve of the coronary sinus and the formation of the sinus.

Brazilian health regions and scales: A geographical perspective

This paper offers a geographical perspective on the way in which health regions have been defined and established in São Paulo as part of overall Brazilian health policy. To accomplish this, I first situate the Brazilian case in the international debate over the regionalization of health services. Second, I examine health regionalization in the case of São Paulo and show how the process is dynamic and complex, involving geographical scales that go well beyond the administrative boundaries of Brazilian municipalities.

Bootstrap confidence regions for canonical variates: Application to studies of evolutionary differentiation

Theory recently developed to construct confidence regions based on the parametric bootstrap is applied to add inferential information to graphical displays of sample centroids in canonical variate analysis. Problems of morphometric differentiation among subspecies and species are addressed using numerical resampling procedures.

Othonella araguaiana (Bivalvia, Megadesmidae) from the Corumbatai Formation (Midlle [Middle] Permian), Eastern Margin of the Parana Basin: systematic, evolutionary and biostratigraphic significances.

In this study, the occurrence of Othonella araguaiana Mendes, a rare bivalve species is reported for the first time in the Pinzonella illusa biozone, Middle Permian Corumbatai Formation, in the State of São Paulo. This species was originally described in coeval rocks of the Estrada Nova Formation (= Corumbatai) from the Alto Araguaia and Alto Garcas regions, State of Mato Grosso. The specimens of O. araguaiana were found in the base of a bioclastic sandstone bed, a proximal tempestite, in the middle of the Corumbatai Formation, in the city of Rio Claro, São Paulo State. The silicified shells and internal molds are well preserved, showing impressions of muscle scars and other internal anatomic characters (e.g., hinge), never illustrated by previous authors. In his original description, Mendes (1963) called attention to the similarity between O. araguaiana and Terraia aequilateralis, a common veneroid of the Corumbatai Formation. Conversely, Runnegar and Newell (1971) suggested that O. araguaiana belongs to Megadesmidae, being a junior synonym of Plesiocyprinella carinata (the commonest megadesmid of the Passa Dois Group). Our study indicates that O. araguaiana is indeed a megadesmid, but is distinct from the P. carinata. The new occurrence of O. araguaiana demonstrates that a) the paleobiogeographic distribution of this species is wider than previously thought (that it was restricted to the northern part of Parana Basin, Mato Grosso State); b) the molluscan fauna of the Corumbatai Formation (P. illusa biozone) in the State of São Paulo is more diverse and dominated by megadesmids; and c) the composition of the molluscan fauna of the Corumbatai Formation in Alto GarYas, State of Mato Grosso, is essentially the same as that of the P. illusa biozone of the eastern margin of the Parana Basin.

TESA-blot for the diagnosis of Chagas disease in dogs from co-endemic regions for Trypanosoma cruzi, Trypanosoma evansi and Leishmania chagasi

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)